Questions From Individuals with BPD

Written by Kathi Stringer

Considering Leaving a DBT Program

Professional crossed Boundaries


Considering Leaving a DBT Program

Question

I have been in a DBT program for 20 weeks due to my intense worshipping to a punishing God that I grew up with, the staff and I have had several misunderstandings. It is almost my time to leave the program and I feel that I am not ready; however, because the past 20 weeks I have been what I call myself is a "high maintenance" client and I do have severe and complex PTSD, I want to ask for the end of Dec. to be the end of my program. I feel as though the staff would rather just get rid of me, I haven't made much progress and that I am a failure. (tears) xxx

Answer

With severe BPD, 20 weeks of DBT is only a blink of time. It takes years in most cases to treat borderline personality disorder. Of course there will be misunderstandings along the way. We are talking about borderline personality disorder personalities here. If you are not ready, then you are not ready. You know yourself better then the treaters working with you.

As for being a 'high maintenance' client, many borderline personalities are. In that realm, you are normal. And, many treaters believe that PTSD and borderline personality disorder have much in common. PTSD comes from a stance of pro survival and BPD is looked at as more manipulative, which in most cases is false.

When considering leaving the program, think back if your treaters are frustrated or irritated. It is a normal response for a treater to become frustrated at times when goals are not reached. However, irritation comes from the wish that a client would disappear, which of course can stir rejection and abandonment issues in the client. Think about this and sort out the two. In addition, if a treater is truly a professional, they will encourage you to stay in the program, if not, then it would be wise to consider whether or not you are truly dealing with a professional.

I can see that you are very depressed. When all your thoughts seem heavy and close in on you, try to remember that persistence will always win out. In other words, no matter your thoughts, keep trying, and one day you WILL get there.


Professional crossed Boundaries

Question

I'm a 47-yrar-old female with an M.S. Ed. Teaching 12 yrs. 2 grown daughters (w/degrees) and success. The Psychiatrist I've been seeing for 2 1/2 years started using terminology about 3 months ago about BPD without ever posing (?) for a diagnosis. I was never told a diagnosis from the beginning. From early on, he said we were friends. We've gone for coffee, wings, met him & his daughter at the bookstore. Several times I expressed upset at lack of confidentiality and he got annoyed with me. Everything has changed now. He yells at me really bad & when I’ve told him not to yell at me he says he will. Then he told me I crossed boundaries!!! Every time I try and repair our relationship he screams, " I'm not the one in therapy! This is NOT about ME!!"

Why does one part of my intuition tell me to leave and yet another part of me cries about him? He's 47 too and the head of a psychiatric floor of a hospital. I feel terrible. I feel worse than when I started therapy (because of a divorce after 28 yrs. of marriage. I know I have some tendencies of BPD, but can't they mimic PTSD? I was sexually, physically, and emotionally abused as a child. Please help me. I feel so frightened about being a BPD! Thank-you, xxx.

Answer

It appears this psychiatrist did not act professionally. He 'did' violate professional boundaries when mixing a casual relationship with professional therapeutic interventions.

For goal setting and care planning, he should have included you as to the information of your dx. After all, how can goals be set if one does not understand the symptoms?

Additionally, needless dependence/negative transference issues have risen because he allowed a relationship to develop outside of the office.

As for staying because he 'has the power to write things about you that aren't true", he has that power regardless if you decide to stay or leave. So this should not be an issue for deciding to continue (mis) treatment with him.

As for him using terms to sidetrack you, it is exactly that. At least it appears that way from what you have told me.

He 'screams' at you. This is poor countertransference management (Stringer) [3]. He is supposed to be the 'professional' and not you.

Last, it is ALWAYS sad to connect to a person that continues the abuse cycle. Based on your history with your family, it is repeating again through him via ‘The Trauma Bond’. See more here:

The Trauma Bond (Ross) [1]

and here

The Victim-Rescuer-Perpetrator Triangle (Ross) [2]

This is all I can do, to advise. If it were me, I would leave. Now. Magical thinking is not going to repair anything.

Sorry you are going through so much. Take courage,

Kathi Stringer

Reply

Thank-you, Kathi for responding to my e-mails. I tell my students if they have an "uh-oh feeling" they should listen to it because nature gives us these instincts. I should follow my own advice no matter how sad I feel. Staying will only prolong the pain. I wish I didn't feel like it's all my fault. Thanks, again, xxx

1. The Trauma Bond - Colin Ross M.D. - Edited / Kathi Stringer
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2. The Victim-Rescuer-Perpetrator Triangle - Colin Ross M.D.
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3. The Secret Language of the Psychotherapist - Kathi Stringer
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